Robert J Kozlow, DDS

Primary specialty

DentistTaxonomy code 122300000X

License

2239 Issued in NH

Practice address

29 Elliott St
Laconia, NH 03246-3130

Phone

(603) 527-7112

Fax

(603) 527-2835

NPI assigned

Feb 22, 2006

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: No
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1140566400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1598730509",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1327",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032471327",
            "telephone_number": "603-524-3211",
            "fax_number": "603-527-7038"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "29 ELLIOTT ST",
            "city": "LACONIA",
            "state": "NH",
            "postal_code": "032463130",
            "telephone_number": "603-527-7112",
            "fax_number": "603-527-2835"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZLOW",
        "first_name": "ROBERT",
        "middle_name": "J",
        "credential": "DDS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-02-22",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "",
            "desc": "Dentist",
            "state": "NH",
            "license": "2239",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "30301540",
            "state": "NH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Jonathan Koert, BS
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• Rita Marie Krupa, PT
• Shamai Kurbitaeva, M.D.
• Labelle's Shoe Repair LLC

• Dentist in Laconia, NH
• Providers in Laconia, NH by specialty
• Dentist in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.